Tag Archives: porcelain veneers

Novocaine or Sedation for Porcelain Veneers?

I am on the cusp of getting porcelain veneers. I am a bit concerned about the procedure. I have a sensitivity to Novocaine as well as any drugs which can make your heart race. A friend of mine recently had the porcelain veneers procedure done and said that the green topical agent they put on her teeth made her very shaky and nervous. This went on for almost fifteen minutes. Do you know if there is epinephrine in the medication used in the procedure? If so, would I be better off having this done with dental sedation?

Sally


Dear Sally,

An image of a porcelain veneer being held up to a tooth.

Epinephrine’s function in a Novocaine injection is to restrict the blood flow and keep the medication more effective. However, any epinephrine in a body would have very little effect on the symptoms your friend experienced. It is more likely that she was dealing with anxiety. That would be a much higher amount of epinephrine than what would be in the medication given to you.

My advice would be to use a mild relaxant along with the Novocaine, such as nitrous oxide. This will keep the epinephrine in your body from getting too high and causing the issues you are concerned about. As I mentioned earlier, any epinephrine in the medication would be miniscule compared to a body’s reaction to anxiety.

I do not recommend you use a stronger dental sedation such as oral conscious sedation. Though stronger, you will not be lucid. Your dentist should place your porcelain veneers on with a temporary try-in paste. This is so that you can get a good look at the veneers and approve of them before they are permanently bonded on.

If you are practically asleep, as you would be from oral conscious sedation, then you would have no way to approve or disapprove the smile makeover. That is important.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

How Much Do I Need for a Smile Makeover?

I am a tad confused about something and hope you can help clear some things up. I want to get porcelain veneers but in order to do that, my dentist is insisting I also get teeth whitening and Invisalign first. I was under the impression that porcelain veneers can make your teeth look white and straight. My teeth aren’t really crooked enough to justify a full orthodontic case. I just have one front tooth that crosses over the adjacent tooth. Have I misunderstood this completely?

Theodora

Hi Theodora,

Porcelain veneer being added to a tooth

Let’s start with the teeth whitening. Whether or not this is useful to you depends on how many veneers you are getting. Very few people can afford to get a porcelain veneer placed on every tooth. That means the other teeth may need some whitening done in order to match your porcelain veneers. Most smiles are 8-10 teeth wide. If you’re only getting four or six veneers, you’ll want to whiten your teeth first to have everything blend naturally. The same goes for your bottom teeth. I doubt you want to spend money to veneer your bottom arch. In most cases, people get enough veneers on their top arch to have a beautiful smile and only whiten the bottom arch.

The Invisalign is a completely different story. Given the scenario you described to me, I don’t think you need orthodontics. Porcelain veneers done well can take care of that issue. The fact that your dentist is suggesting Invisalign tells me that he or she is not comfortable reshaping your teeth for the procedure. Don’t force his hand. Instead, find a cosmetic dentist who has done this lots of times and will be skilled getting it done.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Can a Dental Flipper Make Teeth Look Straight?

I have crooked teeth but feel I am too old for braces. I’ve heard about a dental flipper that can snap onto your teeth and make them look straight. Will this really work?

Theresa

Dear Theresa,

A dental flipper

A dental flipper

I think whoever told you this had a dental flipper confused with the snap-on smile. A dental flipper is used to replace a missing tooth. It does not fit over a tooth. In case someone reading this is looking into tooth replacement options, a flipper is considered a temporary replacement. It’s inexpensive and people use it to give themselves a “tooth” while they save up for a permanent replacement, such as a dental implant.

Having a Straight Smile Without Braces

Snap-on Smile is something that will snap over your teeth in order to make them look better. They will not look stunning, like they would with porcelain veneers but they will look okay. They are more suitable for something like a photoshoot or one-night class reunion. They are made of acrylic and would need to be replaced every few years.

An image of Invisalign aligners

These days we have better options than ye olde fashioned traditional braces. Now, there is Invisalign. Instead of metal wires and brackets, it uses clear aligners. These are invisible, even at a conversational distance. These are more comfortable than braces and work in significantly less time.

You can go with the snap-on smile and it will give you a decent temporary solution. My suggestion, however, would be to plan long term and get Invisalign. It has an additional hidden benefit of enabling you to whiten your teeth at the same time as you straighten them. The aligners can double as teeth whitening trays. It is like getting a mini smile makeover at a fraction of the cost.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
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Options for a Tooth Gap

I have an 8mm gap in my front teeth. My dentist is suggesting I get Lumineers to fix that but I’m a bit nervous about that. I see the Lumineers have mixed reviews. Are there other options for me that do not include 3 years in metal braces?

Cameron

Dear Cameron,

An image of Invisalign aligners

Whatever you do, please do not allow your dentist to do Lumineers on your teeth. For one, 8mm is enough space for a whole other tooth. This is a very complicated case for any brand of porcelain veneers and you are correct that Lumineers is touch and go at best. This is due to two factors.

1. They are highly advertised to inexperienced cosmetic dentists. You would need one of the top 1% of cosmetic dentists for your particular case.
2. The company that owns Lumineers insists dentists use their lab, which is not known for having excellent results.

My suggestion would be for you to get Invisalign. This can straighten your teeth and close that gap in half the time of traditional braces. Not only that, they can do it invisibly. There are no metal wires and brackets. Instead, Invisalign uses clear aligners. These are much more comfortable and, because they are removable, it is simple for you to brush and floss your teeth.

They have an additional hidden benefit of allowing you to whiten your teeth at the same time. This is because the aligners can double as teeth whitening trays. It is like getting a mini smile makeover at a fraction of the cost.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

When Does a Tooth with a Root Canal Treatment Need a Crown?

I have a root canal treatment that has never been crowned. Recently, I read that is a mistake. Should I get this crowned? I used to have dental insurance, but now I don’t so I don’t want to spend the money if I don’t have to. What are your thoughts on it?

Bruce

Dear Bruce,

I’m very glad this question came up because I have seen some people just crown every tooth that had a root canal. In some cases that can do more harm than good. Much of the answer to this question will depend on which tooth you are talking about. If it is a back tooth, such as a molar, then I would say to crown the tooth. It will protect it from the type of biting forces those teeth face. With other teeth, it gets more complicated.

illustration of a a front tooth

The biting stresses on a front tooth and their adjacent teeth are mostly horizontal because of the tearing stress. This means the neck of the tooth is the most vulnerable. By the time you prepare a tooth for a dental crown, it loses a minimum of 30% of its diameter, putting additional stress at the neck of the tooth. If that tooth also lost a significant amount of structure before the root canal treatment because of decay, there will be even less structure there.

If you place a dental crown on a front tooth that doesn’t have the necessary diameter to support the forces it is subjected to, it could end up breaking at the gumline. Some dentists try to overcome this by placing a post in the tooth, though that can increase the chances of the root fracturing, which will require an expensive repair.

The issue with front teeth after a root canal is that they tend to turn dark, which becomes an appearance issue. Our smiles are one of the first things people notice about us so we want them to look as nice as we can. Here is my advice on how to keep its white color longer and what to do when it does turn dark.

Helping a Tooth with a Root Canal Keep its Color

Your dentist needs to thoroughly clean out any root canal material and cement from the crown of the tooth, these are huge contributors to the dark appearance. Next, he or she should place a white fiberglass post into the tooth. Fiberglass is more flexible and will help with the stress. Finally, fill the remainder of the open area with white composite filling material. Doing this will extend your tooth’s color.

If it does eventually turn dark, instead of crowing it, I would suggest a porcelain veneer placed on that tooth. That removes far less structure, which will be better for the tooth viability in the long run.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
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Need affordable dentist to correct veneer work

I have battled with the appearance of my teeth for my entire life. I have chips in both of my front teeth and another tooth, also in the front of my mouth, is badly twisted. I am sure I should have had braces when I was a child, but I was one of seven children, so that wasn’t in the cards. I researched to find an affordable dentist for veneers, but am not at all satisfied with the results. They are unnatural looking, almost to the point that it looks like fake teeth have been glued on top of my natural ones, not to mention the twisted tooth is still severely-twisted looking. I really need an affordable dentist, skilled enough to to correct these issues. Is this possible?

Thanks,
Bobbi

Dear Bobbi,

Cosmetic work is not something you should look for in an affordable dentist. Sure, the costs vary from office to office, as do the rates, but if you focus on cost alone, your results will be sub-par, which is what you are experiencing now. Cosmetic dentistry is a practice which requires an amount of skill which is not possessed by all dentists. Therefore, you should focus your search on looking for a quality cosmetic dentist, then look at costs.

It is important to look at examples of a dentist’s work. Many share their work in smile galleries on their office sites. These allow you to browse at your own leisure, and will give you a good idea of what to expect. Also be sure to read reviews of cosmetic dentists from patients who have had the same treatment you hope to have. Just because a dentist does beautiful crown work, doesn’t mean he or she has the same quality veneer experience.

You should also keep in mind that veneer work is not necessarily something an insurance company will cover. However, financing through a company such as Care Credit, may be an option to help with the costs of a cosmetic dentist. Focusing on the quality of the cosmetic dental work will yield beautiful results for many years. Focusing on the cost may cause you to have veneer work done again, just as you are now.

This article was brought to you by the office of Gilbert affordable dentist, Dr. Matthew Roper.

Should I whiten and straighten before porcelain veneers?

I am thinking about getting porcelain veneers since I don’t love my front teeth, especially my top ones.  I have looked a little and know it’s expensive to get porcelain veneers, so if I’m going to get them, I want them to look the best they can.  Should I do teeth whitening and invisalign before I get veneers so my teeth will be perfect when I’m done?

Thanks,
KC, San Diego

Dear KC,

Someone's "perfect" smileYou mentioned you wanted perfect teeth. “Perfect” for you may mean something different than another patient. “Perfect” may be dazzling white and perfectly straight teeth.  Maybe “perfect”  is whiter, straighter, natural-looking teeth that are better than what they are now. No matter what your definition of perfect is, it is important to consider your answers before spending the money on porcelain veneers, whitening, or invisalign.

Should I whiten before getting porcelain veneers?

If you are unhappy with the general color of your teeth before veneers, whitening is a step that needs to happen before you start the porcelain veneers. Veneers themselves do not whiten. Good cosmetic dentists will match the color of your porcelain veneers to your regular teeth so they look more natural. If you want the new veneers to be matched to whiter teeth, complete this step before you start the porcelain veneers.

Should I straighten my teeth before porcelain veneers?

It is not necessary to straighten  crooked teeth before you start. That’s one of the beauties of porcelain veneers. They can make your teeth look straight. Invisalign isn’t necessary.  It won’t affect the placement of the veneers and will save you a lot of money, especially if your teeth aren’t too crooked. If you are generally not happy that several of your teeth, top or bottom, are crooked and you are only planning to get a couple of veneers, it may be something to consider.

The best path for you to take to get the smile you want is to discuss your “perfect” teeth with a cosmetic dentist. Ask for his or her opinion about your treatment plan. Discuss your options so you are comfortable and happy with what the outcome will be before you start anything.

This post is sponsored by Vista Dorada Dental in Gilbert, AZ.

 

 

Do I Need a Special Dentist for Invisalign?

I want to get my teeth straightened with Invisalign. Do I go to a special dentist like an orthodontist or cosmetic dentist or will my regular dentist do?

Charles I.

Dear Charles,

A woman placing her Invisalign aligners

There are certain things which require a specialist, but Invisalign isn’t one of them. In fact, not even cosmetic dentistry is a recognized specialty. Any general dentist is technically allowed to call themselves a cosmetic dentist. Obviously, a patient needs to be cautious about getting an advanced smile makeover done by just any dentist because skills vary from dentist to dentist, so you’ll want to check out why type of results they get before committing.

Even though orthodontist is a recognized specialty, a general dentist can do braces and other orthodontics if they’ve invested the time in training. Many have, and many patients find they save money by going to their family dentist for their braces.

Invisalign is different from all of those procedures. The treatment plan and design of aligners is done by computer with a special software program designed to make your treatment plan as efficient as possible. Results are likely to be the same across the board no matter which dentist you go to for treatment. If your dentist offers Invisalign, you’ll be safe to get it done from him (or her).

Bear in mind, not everyone is a candidate for every procedure. If you’re not, you have options.

Options to Invisalign

  • Traditional Braces: Most people are a candidate for Invisalign. Every so often, though, we run up against a case that has much more severe issues than normal with their bite. In that case, traditional braces may be the better route for you.
  • Porcelain Veneers: If there are more things you’re interested in changing about your smile than just some orthodontics, a smile makeover may be just the thing. While these won’t actually straighten your teeth, they can be designed to make your smile look straight. Additionally, they can change the shape, size, and color of your teeth at the same time.

I hope this helps. Talk to your dentist about your goals. Together you can come up with all your best options.

This blog is brought to you by Dr. Matt Roper.

Is there a “poor man’s” smile makeover?

I looked into getting a smile makeover, but the price was through the roof.  Is there  a “poor man’s” smile makeover. Something that can really improve my smile, but won’t require me to sell my SUV to pay for it?

Mark A. – Philadelphia

Mark,

Hah! Well there are a couple of options.

  1. You can get the smile makeover you want with a qualified cosmetic dentist that will allow you to pay it out. Some dentists have low or even no interest payment plans.  Find the dentist you want and then talk to them about financing options. There are dentists that don’t advertise more affordable options, but are willing to work with you if you ask.
  2. There is a more affodable procedure that will make a huge difference on your smile. Teeth whitening can make your teeth look years younger.

Though it doesn’t sound like much, you’ll be amazed at the brilliance and youthful appearance you’ll take on from that one simple procedure.

This blgo is brought to you by Dr. Matt Roper.

Is being a test case an affordable way to get a smile makeover?

I have always been embarassed about my smile. Always. However, I am quite poor. I’m a single mom and work two jobs just to make ends meet. There is no way in the world I will ever be able to afford a smile makeover. Last week my dentist mentioned that he is learning how to do porcelain veneers. He knows my financial situation and offered to do them for free if I would be a practice case for him. Is this a safe way to get a smile makeover? It’s certainly affordable.

Amy R. – Missouri

Amy,

Normally I would say run away from a situation like this, but I’m not going to this time. Not just because it is an affordable way to get a smile makeover. In this case I think your dentist cares and isn’t just using you. Before you agree, there needs to be a stipulation. If your dentist doesn’t agree to it, I don’t care how affordable the makeover is, it won’t be worth it.

You must insist that you get to preview the veneers before he cements them on permanently. Your dentist can use a temporary  try on paste. This way you can make sure you’re in love with them before it is too late.

If you try them on and aren’t completely and totally in love with them, he needs to send them back to the lab and try again.  This is something even expert cosmetic dentists do.  The point of cosmetic dentistry is to make sure the patient feels beautiful when they smile.

If he’s willing to do that, then you’ll get a fantastic deal.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.